A Study on Prevalence of Preventable Skin Diseases and their Risk Factors among Households in Selected Slums of Chennai, Tamil Nadu – 2014

BACKGROUND: In developing countries, skin diseases have a serious impact on people’s quality of life and bring out a significant burden to the nation. They have a high morbidity but very little mortality and are neglected both by the community and the health personnel. Preventable skin diseases are those infections and infestations of the skin that can be avoided by good hygiene practices and by improving the living conditions of the individuals. According to WHO, these diseases have the greatest importance in terms of public health. The prevalence of skin diseases in population based studies conducted in India vary from 14% to 50%. Simple approaches like promoting hygiene in the community, improving their housing standards, preventing overcrowding, better health education and improving the socioeconomic status of the community may bring down the burden of these skin diseases drastically. OBJECTIVES: To estimate the prevalence of preventable skin diseases and its risk factors among individuals residing in households in the selected slums of Chennai in 2014. MATERIALS AND METHODS: A community based cross sectional study was done among households in the slums of Chennai during February to May 2014. 520 individuals residing in 107 households were selected by multistage cluster sampling method. In each household, all the members were selected for the study. History related to their hygiene practices was obtained using a pretested semi-structured questionnaire and head to foot examination of skin and its appendages was done indivudually in day light to assess their general appearance and to find out the presence of preventable skin diseases.The association between various factors and skin diseases were analyzed by using Chi Square test. RESULTS: The members in each household ranged from 1 to 10. More participants were in the 30 to 39 years age group and females were more compared to males. The study revealed the overall prevalence of preventable skin diseases was 86% among households and 46.3% among individuals (95% CI - 42.01% to 50.59%). The most common skin diseases were the parasitic infestation (43.9%) followed by fungal infection (42.50%) with pediculosis capitis (35.4%) being the most common diagnosis. Preventable skin diseases were significantly higher in children and adolescents and also among females. 90.6% households were overcrowded, 84% individuals share their sleeping place with others, 41.7% participants did not take bath daily, 65% participants shared their soaps, 68.5% individuals shared their towels, 73.3% participants shared their combs and hand washing practices of the individuals were very poor. A significant association was found between preventable skin diseases and type of house, overcrowding, frequency of taking bath, application of oil to body, place of taking bath and poor general appearance. Conclusion: Alarming prevalence of preventable skin diseases of 46.3% among individuals and 86% among households highlights the need for screening programmes for slum dwellers for early diagnosis of skin diseases. Health education interventions should be given to improve the hygiene practices among households in the slums